What is a common sign of acute otitis media in toddlers that a nurse should monitor?

A common sign of acute otitis media in toddlers is ear pulling. This behavior often indicates discomfort or pain in the ear, as toddlers may instinctively pull at their ears to signal the location of their symptoms. Ear pulling, along with other signs of discomfort, is an important observation for nurses when assessing a child with suspected otitis media, as it can help corroborate other clinical findings and guide treatment decisions.

While high fever and persistent crying might also be observed in some cases, they are more general signs of illness and can be indicative of various conditions. Difficulties in hearing may occur as a secondary effect of the fluid accumulation associated with otitis media, but it is not typically the first or most noticeable symptom in toddlers. Thus, ear pulling is a more direct and specific behavioral response to the discomfort caused by the ear infection.